Randomised Controlled Trial Evaluating Active versus Passive Waiting for Speech-Language Pathology

Abstract

<b><i>Introduction:</i></b> High demand for speech-language pathology means children sometimes wait over 12 months for services, missing out on timely support. Waiting can be a time of stress, concern, and powerlessness for caregivers. Provision of information via a website may support families and encourage active waiting. <b><i>Objective:</i></b> The aim of this study was to compare children’s speech, intelligibility, language, and literacy outcomes, and caregivers’ satisfaction and empowerment in active versus passive waiting conditions. <b><i>Methods:</i></b> Ninety-seven preschool-aged children referred to a community health speech-language pathology service in Australia were screened for eligibility. Eligible children (<i>n =</i>42) with speech/language difficulties were randomly allocated to: (a) active waiting (provision of a purpose-built website; <i>n</i> = 20), or (b) passive waiting (control group; <i>n</i> = 22). Pre- and post-assessments (after 6 months on a waiting list) were completed with children and caregivers by a speech-language pathologist blinded to group allocations. <b><i>Results:</i></b> Intention to treat (<i>n =</i>36) and per-protocol analyses (<i>n =</i>30) were conducted to measure group differences in child and caregiver outcomes at post-assessment using one-way ANCOVA, controlling for baseline scores. There were no statistically significant differences between groups for children’s speech, intelligibility, language, and literacy, or caregivers’ empowerment and satisfaction. Children in both groups made minimal gains over 6 months. <b><i>Conclusions:</i></b> Provision of an active waiting website did not lead to statistically significant change in child or caregiver outcomes, and children in both groups made little progress over a 6-month period. Early speech-language pathology intervention delivered with appropriate dosage is needed to optimise children’s outcomes. Until timely and effective speech-language pathology intervention can be provided for all who need it, provision of early assessments may be beneficial. There remains a need for effective ways to support children and families on waiting lists.